Infected forearm nonunion treated by bone transport after debridement

Abstract

BackgroundThis is a therapeutic study to evaluate the results of the management of forearm infected nonunion using bone transport with external fixators after debridement.MethodsWe have retrospectively reviewed a consecutive series of 21 patients from October 1994 to June 2010 in our institution who were treated for the forearm infected nonunion by bone transport with external fixator after debridement. There were 12 males and 9 females. The mean age of the patients was 27.1 years. Of the initial fractures, nonunion of the radius alone invovled in 7 patients, nonunion of the ulna alone invovled in 12, and nonunion of the radius and ulna invovled in 2. Nineteen limbs (85.7%) were in active infected state with sinus and drainage. The mean amount of bone defect was 3.1 cm (range 1.8-4.6 cm) as measured on plain radiographs.ResultsThe mean follow-up was 77.5 months. All patients achieved bony union and were satisfied with the functional and cosmetic outcome. All the infection had been controlled. The mean external fixation index was 42.5 day/cm. The average time for wound healing was 42 days. The mean length gained was 3.5 cm (2.1-5.3 cm).ConclusionsThe technique of bone transport after debridement is a safe, effective, and minimally invasive treatment for forearm infected nonunion.

Bone transport for the treatment of infected forearm nonunion

“…In our study, the mean degrees of forearm pronation and supination were better than the 68.38 and 70.78 reported by Liu et al [3] and the mean degrees of wrist flexion and extension were similar to the 50.78 and 51.08 reported by Liu et al [3] The external fixation index was higher than the 42.5 days/cm reported by Liu et al [3] and the reason may be a larger size of bone defects in our study. The mean complications of every patient was 1 (16/16), which was lower than the 1.86 (39/21) reported by Liu et al [3].…”

“…The mean complications of every patient was 1 (16/16), which was lower than the 1.86 (39/21) reported by Liu et al [3]. The pin-track infection rate was 62.5% (10/16), but the degree of pin-track infection was slight.…”

“…Hence, bone transport has gradually been a major treatment for infected nonunion, particularly in the lower extremity [19][20][21][22]. However, reports on the treatment of infected forearm nonunion by bone transport were rare [3,4]. Therefore, we conducted this study of bone transport for the treatment of infected forearm nonunion.…”

Mg2+ in β‐TCP/Mg–Zn composite enhances the differentiation of human bone marrow stromal cells into osteoblasts through MAPK‐regulated Runx2/Osx

“…The healing process of fractures is physiologically complex and delicate; the percentage of delayed or nonunion after fractures is approximately 10% (Liu, Liu, Ling, & Zhang, ; Wan et al, ; Zura et al, ). Bone loss has been considered one of the critical reasons for nonunion (Hak et al, ).…”

Independent segmental bone transport of the radius and ulna: A case report

“…[2][3][4] When dealing with forearm non-unions and bone loss, soft tissue adhesions and scar tissue need to be addressed. 4 As was the case in this instance, meticulous attention to rehabilitation is needed to optimise the functional outcome. A cement spacer was used to manage the transport space.…”